<p class="abstract"><strong>Background:</strong> The anterior tibial spine fracture occurs almost at a same frequency both in adolescents and in adults. These injuries are often overlooked at emergency room. Stable internal fixation requires to gain optimum function of ACL by securing its length and nascent tension. We treated anterior tibial spine (ACL avulsion) fracture patient with open reduction and screw fixation.</p><p class="abstract"><strong>Methods:</strong> Study of Ten patients of anterior tibial spine (ACL avulsion) fracture, with minimum of 06 months and maximum of 18 months follow up. Classification of anterior tibial spine (ACL avulsion) a fracture done by Meyer and Mckeever. All patients operated with open reduction and internal fixation with screw via medial parapatellar approach. Functional and clinical outcome measured with Lysholm knee score at final follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> We studied 10 patients with anterior tibial spine (ACL avulsion) fractrure where mean age of patient was 36.4 years. Mean radiological healing was 10.6 weeks in anterior tibial spine (ACL avulsion) fracture. We observed mean motion of knee 133 degree in anterior tibial spine (ACL avulsion) fracture. Mean Lysholm score at final follow up was 86.8.</p><p class="abstract"><strong>Conclusions:</strong> Open reduction for anterior tibial spine (ACL) fracture provides direct visualization with easy application of screws ultimately confers stable osteosynthesis enables to start early range of motion and further rehabilitation protocol. Open reduction internal fixation is comparative less technically demanding, less expansive and gives excellent to good results as compared to other techniques.</p><p class="abstract"> </p>

Background: Distal third humerus shaft fractures are difficult entity to manage with. Regional Anatomy and acting forces at the region makes its management tricky to have a good functional results. Conventional platting when used have a limited distal fragment purchased. we used anatomical precontoured single 3.5 mm locking plates in 11 patients with distal third extra articular humerus fractures. Materials and methods:We have studied a retrospective study of 11 patients presented to our institute with an extra articular distal third of humerus fracture between January 2017 to June 2018. All patients were approached through posterior midline incision. Osteosynthesis had been achieved with precontoured 3.5 mm anatomical locking plates. Minimum follow up of 6 months had been taken. (range 6-24 months).all patients had been evaluated according to mayo elbow performance score at final follow up. Results: We have evaluated 11 cases of closed distal third extraarticular humerus fractures. We have included patients with mean age of 39 years in our study. There were 8 male patients (72.73%) and 3 feamale patients (27.27%). In our study maximum numbers of patients had injuries due to road traffic accidents 8 cases (72.7%) followed by domestic fall in 3 cases. Mean Range of motion at elbow was 122.27. We found excellent results in 9 cases (81%) and good to fair results in 2 cases. None of the patient had undergone for any revision surgery. Conclusion:In the management of the extra articular distal third fracture of humerus optimal osteosynthesis with rigid fixation is required to achieve good functional outcome. Use of precontoured 3.5 mm anatomical locking plates in such fractures gives rigid fixation and allows early mobilization.

Introduction: Metacarpal fractures are among the most commonly treated upper extremity injuries in adults, and represent about 10% of all fractures. In this study we described a technique with antegrade pre bent blunt tip k wire fixation for 5 th metacarpal neck fracture in 15 patients with good functional outcome. Methods: Our study was conducted Between January 2016 and June 2017. In our study 15patients with fifth metacarpal neck fracture underwent surgical treatment with antegrade blunt tip k wire. A single blunt tip k wire with suitable diameter was used in 15 cases of fifth metacarpal neck fractures with dorsal angulation over 30°. An entry point was taken at the ulnar-dorsal base of the 5th metacarpal. The k wire was inserted in an antegrade approach. The k-wire was usually removed at about 4 weeks postoperatively after clinic radiological signs of union. Results: At final follow up, all fractures proceeded to bony union. The mean total active motion (TAM) was 263°. Mean preop neck shaft angle is 54.2 (n=15), mean post op neckshaft angle is 9.4. mean dash score 2.7 was observed.. At 6 months follow up, all 15 patients had an excellent to good results and able to continue their routine work daily without any difficulty Conclusions: Antegrade intramedullary technique with pre-bent blunt-tip k wire is preferred as this method is technically simple, cost effective, less invasive, less perioperative complications, reproducible with excellent to good functional outcomes.

Background: Closed manipulation and percutaneous screw fixation, minimal sinus tarsi approach reduction and screw fixation, open reduction and plate fixation these all useful in management of intraarticular calcaneus fracture management. In this study we used all these three different methods and evaluate outcome on postoperative follow up with different modalities of treatment. Material and Methods: A series Twenty-Five patients with intraarticular calcaneus fractures were included in this analysis. Essex-Lopresti classification was used to evaluate the injuries and their prognostic correlation tested. Bohler's angle and Gissane`s angle was measured preand postoperatively and evaluated as radiological outcome. Clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS). Results: A total of 25 patients with intraarticular fractures out these 24 patients having unilateral calcaneus fracture and 1 patient having bilateral calcaneus fracture. All were male patients with a mean postoperative follow-up of 24 months. Overall mean age of patient was 48 years old. The most frequent cause of trauma was a fall from a height. According to Essex-Lopresti, there were 21 joint depression type fractures, and 4 tongue type. Clinical outcome on follow up measured with AOFAS score and we found out of 25 patients 13 patients with excellent AOFAS score,10 patients with good AOFAS score and 2 patients with fair AOFAS score. The restoration of the Bohler's angle and Gissane's angle achieved most frequently. Conclusion: Internal fixation either in the form of percutaneous screw fixation or plate fixation effective and useful in management of intraarticular calcaneus fracture.